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01.11.2014 | Original Article

Bone health in children and adolescents with steroid-sensitive nephrotic syndrome assessed by DXA and QUS

verfasst von: Gabriella Aceto, Olinda D’Addato, Giovanni Messina, Vincenza Carbone, Luciano Cavallo, Giacomina Brunetti, Maria Felicia Faienza

Erschienen in: Pediatric Nephrology | Ausgabe 11/2014

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Abstract

Background

The management of steroid-sensitive nephrotic syndrome (SSNS) requires treatment with high-dose glucocorticoids (GCs), but GC usage causes the most frequent form of drug-induced osteoporosis. The aim of our study was to evaluate the impact of GCs on bone mineralization in patients with SSNS using two diagnostic tools, dual-energy X-ray densitometry (DXA) and quantitative ultrasound (QUS), and to compare the diagnostic efficacy of these two imaging tools.

Methods

A total of 30 children with SSNS (age 5.20 ± 2.20 years) were evaluated at the start (T0) and after 1 (T1), 2.44 ± 0.75 (T2, 18 patients) and 5.96 ± 2.33 years (T4, 12 patients) of GC treatment. Patients who stopped at T2 were also evaluated at the 1-year timepoint after ceasing GC treatment (T3).

Results

Of the patients assessed at T2, 11 had bone mineralization at the lower limit of normal versus those at T0 and T1, with bone mineralization rescue at the 1-year timepoint after GC discontinuation. At T4, 6/12 patients had densitometric parameters at the lower limit of normal values, and 3/12 patients showed reduced bone mineralization. The parameters derived from measurements of DXA and QUS were significantly related to each timepoint.

Conclusions

Patients with SSNS receiving GC therapy undergo bone status alteration related to the dosage and duration of the therapy. In terms of diagnostic efficacy, DXA and QUS were comparable, indicating that QUS is a reliable tool to evaluate bone health in children with SSNS.

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Titel: Bone health in children and adolescents with steroid-sensitive nephrotic syndrome assessed by DXA and QUS
verfasst von: Gabriella Aceto
Olinda D’Addato
Giovanni Messina
Vincenza Carbone
Luciano Cavallo
Giacomina Brunetti
Maria Felicia Faienza
Publikationsdatum: 01.11.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 11/2014
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-2834-3

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Bone health in children and adolescents with steroid-sensitive nephrotic syndrome assessed by DXA and QUS